Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine
Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity...
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Veröffentlicht in: | Kidney international 1991-11, Vol.40 (5), p.934-938 |
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description | Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P < 0.02); tip colonization (TC) was 17% in T versus 36% in C (P < 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P < 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P < 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P < 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections. |
doi_str_mv | 10.1038/ki.1991.297 |
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Jane ; Jindal, Kailash K. ; Fong, I. William ; Goldstein, Marc B.</creator><creatorcontrib>Levin, Adeera ; Mason, A. Jane ; Jindal, Kailash K. ; Fong, I. William ; Goldstein, Marc B.</creatorcontrib><description>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P < 0.02); tip colonization (TC) was 17% in T versus 36% in C (P < 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P < 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P < 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P < 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1038/ki.1991.297</identifier><identifier>PMID: 1762298</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acute Kidney Injury - therapy ; Administration, Topical ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiseptics ; Biological and medical sciences ; Catheterization, Central Venous - adverse effects ; Humans ; Kidney Failure, Chronic - therapy ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Povidone-Iodine - administration & dosage ; Renal Dialysis - adverse effects ; Sepsis - prevention & control ; Staphylococcal Infections - prevention & control ; Subclavian Vein</subject><ispartof>Kidney international, 1991-11, Vol.40 (5), p.934-938</ispartof><rights>1991 International Society of Nephrology</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-709dde491e3cdfbb234153c0cd4fe51c7052d88cbb464d62cefab71a29799bae3</citedby><cites>FETCH-LOGICAL-c420t-709dde491e3cdfbb234153c0cd4fe51c7052d88cbb464d62cefab71a29799bae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>310,311,315,782,786,791,792,23937,23938,25147,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5483684$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1762298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Levin, Adeera</creatorcontrib><creatorcontrib>Mason, A. Jane</creatorcontrib><creatorcontrib>Jindal, Kailash K.</creatorcontrib><creatorcontrib>Fong, I. William</creatorcontrib><creatorcontrib>Goldstein, Marc B.</creatorcontrib><title>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P < 0.02); tip colonization (TC) was 17% in T versus 36% in C (P < 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P < 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P < 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P < 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections.</description><subject>Acute Kidney Injury - therapy</subject><subject>Administration, Topical</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiseptics</subject><subject>Biological and medical sciences</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Povidone-Iodine - administration & dosage</subject><subject>Renal Dialysis - adverse effects</subject><subject>Sepsis - prevention & control</subject><subject>Staphylococcal Infections - prevention & control</subject><subject>Subclavian Vein</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkDuP1DAURi0EWmYXKmpECrQNyuBHPLFLtOIlrQQFFFSWHzfay2TswU4izb_Ho4yWhsqyvuPv-h5CXjG6ZVSo93vcMq3Zluv-CdkwyUXLeimfkg2lSrZcCvWcXJfym9a7FvSKXLF-x7lWG_Lre4YF4oQpNmloHuCQAtrxVLA0ZXZ-tAva2CyAsfF2eoAJcoNxAH9-Uhp3aqZ0RG_H5pgWDClCi7UiwgvybLBjgZeX84b8_PTxx92X9v7b5693H-5b33E6tT3VIUCnGQgfBue46JgUnvrQDSCZ76nkQSnvXLfrwo57GKzrma3Lau0siBtyu_Yec_ozQ5nMAYuHcbQR0lxMz6WSWqkKvltBn1MpGQZzzHiw-WQYNWeRZo_mLNLU7kq_vtTO7gDhH7uaq_nbS25L3X7INnosj5jslNiprmJvVizaac7wmO_xPGkdJFcCqqQFIZviEaKHgLlaNiHhfz_4FyjGmc8</recordid><startdate>19911101</startdate><enddate>19911101</enddate><creator>Levin, Adeera</creator><creator>Mason, A. Jane</creator><creator>Jindal, Kailash K.</creator><creator>Fong, I. William</creator><creator>Goldstein, Marc B.</creator><general>Elsevier Inc</general><general>Nature Publishing</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19911101</creationdate><title>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine</title><author>Levin, Adeera ; Mason, A. Jane ; Jindal, Kailash K. ; Fong, I. William ; Goldstein, Marc B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-709dde491e3cdfbb234153c0cd4fe51c7052d88cbb464d62cefab71a29799bae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Acute Kidney Injury - therapy</topic><topic>Administration, Topical</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiseptics</topic><topic>Biological and medical sciences</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Povidone-Iodine - administration & dosage</topic><topic>Renal Dialysis - adverse effects</topic><topic>Sepsis - prevention & control</topic><topic>Staphylococcal Infections - prevention & control</topic><topic>Subclavian Vein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Levin, Adeera</creatorcontrib><creatorcontrib>Mason, A. Jane</creatorcontrib><creatorcontrib>Jindal, Kailash K.</creatorcontrib><creatorcontrib>Fong, I. William</creatorcontrib><creatorcontrib>Goldstein, Marc B.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Levin, Adeera</au><au>Mason, A. Jane</au><au>Jindal, Kailash K.</au><au>Fong, I. William</au><au>Goldstein, Marc B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>1991-11-01</date><risdate>1991</risdate><volume>40</volume><issue>5</issue><spage>934</spage><epage>938</epage><pages>934-938</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine. Subclavian catheter (SCC) related infections are a major cause of morbidity in hemodialysis patients, the vast majority due to staphylococci species Povidone-iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized controlled trial of topical PI ointment was undertaken to evaluate the impact of this prophylactic intervention on the incidence of SCC related infections in hemodialysis patients. The role of S. aureus nasal carrier state in the acquisition of infection was also evaluated. Patients requiring SCC for temporary hemodialysis access were randomized to receive the treatment (T; N = 63) or sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210 days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit site (ES) infections were significantly less in T (5%) versus C (18%) (P < 0.02); tip colonization (TC) was 17% in T versus 36% in C (P < 0.01), while the incidence of septicemia (S) was also significantly less in C (2%) versus C (17%; P < 0.01). S. aureus nasal carriers were at a threefold higher risk of SCC related septicemia (0.009/day) than noncarriers (0.003/day; P < 0.05). The beneficial effect of PI ointment was most evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC = 12% T versus 42% C, S = 0% T versus 29% C, P < 0.05. There were no adverse effects of the treatment. The routine application of topical PI ointment to temporary hemodialysis catheter exit sites is effective in reducing SCC related infections.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1762298</pmid><doi>10.1038/ki.1991.297</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acute Kidney Injury - therapy Administration, Topical Antibiotics. Antiinfectious agents. Antiparasitic agents Antiseptics Biological and medical sciences Catheterization, Central Venous - adverse effects Humans Kidney Failure, Chronic - therapy Medical sciences Middle Aged Pharmacology. Drug treatments Povidone-Iodine - administration & dosage Renal Dialysis - adverse effects Sepsis - prevention & control Staphylococcal Infections - prevention & control Subclavian Vein |
title | Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine |
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